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Does Exercise Help Patients with Advanced Heart Failure?

Heart failure continues to be a rapidly growing disease. The Centers for Disease Control and Prevention reports that there are about 5.1 million people in the United States who experience heart failure. About half of those people die within 5 years of diagnosis. In 2009, one in nine deaths included heart failure as a contributing cause.

Exercise training can be a promising part of the treatment for more advanced forms of heart failure

The good news is that exercise has been shown to be a safe and effective part of the treatment plan for patients with mild to moderate heart failure. The HF-ACTION study, the largest randomized controlled study to date, found that exercise training was associated with significant reductions in all causes of mortality and hospitalizations, including hospitalizations related directly to heart failure. Now a 2016 study published in the Journal of Cardiopulmonary Rehabilitation and Prevention has found that exercise helps patients with more advanced heart failure as well.

What is Heart Failure?

Heart failure is a condition in which the heart muscles becomes weakened and cause the heart to work overtime in order to keep up with the demands of blood flow to the body. This condition typically gets worse over time, and often goes undiagnosed until symptoms become very noticeable. If left untreated, heart failure can occur over time from a variety of symptoms including high blood pressure (hypertension), heart attack, damage to the heart valves, enlargement of the heart, family history and diabetes.

Common treatment for heart failure includes monitoring your diet to limit sodium as well as monitoring fluid intake. Certain medications are also prescribed to help the heart work more efficiently.

Advanced Heart Failure and Exercise

If you have a more advanced version of heart failure, the question is always whether exercise will hurt or hinder your situation? In the past, exercise wasn’t recommended for heart patients who experience shortness of breath, fatigue and other symptoms. More recent research investigating the effects of long-term exercise training in patients with advanced chronic heart failure has found that exercise did benefit this group.

During the study, subjects exercised for 20-30 minutes per day for up to 12 months. The results of this study conducted over one year (with evaluations at 3, 6 and 12 months) showed improvements in exercise capacity of 27% and improvements in left ventricular performance of 14% measured by echocardiogram. Also important to note is the rate of clinical events in this higher risk population. Over the 12-month period, there were no hospitalizations related to heart failure during an exercise session while there were six hospitalizations at non-exercise times, which were related to various adverse events such as arrhythmia.

The results of this study are encouraging to this ever-growing patient population. We can only hope that more research will continue to show the benefits of exercise for heart failure.

What this study shows is that if someone is motivated, with the proper physician support and medical therapy, exercise training can be a promising part of the treatment for more advanced forms of heart failure. If you or someone you know is interested in starting an exercise program be sure to coordinate this with your cardiologist or family physician. Their support and guidance is critical to help exercise be a safe part of your treatment plan.

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Have something to contribute?

My doctor said not to do any exercise that requires using arms. Is this related to the muscle connected to the chest?

Phil Hardesty March 30, 2016

Only your doctor knows why he specifically wants you to limit arm exercise so I would suggest asking him at your next appointment. It could be because adding arms to any most exercises will increase the workload of the heart.